Inequalities in access to GP care in Ireland: An analysis using longitudinal data

The principle of equal treatment for equal need is a key component of health policy. However, Irish and international evidence shows that factors other than health need are important in determining healthcare use. For example, there is extensive evidence that those who must pay for general practitioner (GP) care have fewer visits than those who receive free care. This in turn has implications for health outcomes, including the extent of undiagnosed chronic illness. This project uses data from two large studies of children and the older population in Ireland to analyse these issues. The data on children come from Growing Up in Ireland (GUI), an ongoing study of the lives of nearly 20,000 children, aged nine months and nine years when first surveyed. The data on the older population come from The Irish Longitudinal Study on Ageing (TILDA), an ongoing sample of over 8,000 people aged 50+ years. The data from GUI and TILDA include information on healthcare use, physical and mental health, health behaviours, public healthcare eligibility, family background, household income, education, In addition, we can link these data to information on the location of GP surgeries and other health facilities (e.g., emergency departments (EDs)) to calculate distances to healthcare facilities for each survey participant. We use these various data sources to examine the determinants of GP service use, and use TILDA to further examine the factors that lead some individuals to be unaware that they have a chronic illness such as hypertension, high cholesterol, irregular heart rhythm, osteoporosis and depression. Many of these chronic diseases are known risk factors for more serious conditions such as heart disease and stroke. The aim is to provide practical evidence for policymakers and health practitioners seeking to ensure that healthcare resources are directed to those in need of healthcare.